as CT better resolution and accurate image of an object true scale 1:1 than CBCT.
In my opinion, the choice should not be based on the professional skills, but on the advantages and disadvantages of each diagnostic method.
Literature is still controversial regarding accuracy: although there are references stating that CBCT would lead to better dimensional accuracy, the clinical relevance of this has not yet been discussed. Adding to that, there is the fact that deriving bone density from CBCT images is a known problem, and this should not be done. But, most important, we have to follow the ALARA principle, and latest guidelines claiming that the smallest possible FOV, together with the highest possible resolution should be used, in those cases in which a 3D evaluation will add substantial information to the treatment plan. With that as a background, the professional must consider which information is needed, adding radiation dose as one parameter which must be considered.
A comparative study of the accuracy and reliability of multidetector computed tomography and cone beam computed tomography in the assessment of dental implant site dimensions. Al-Ekrish AA1, Ekram M. Dentomaxillofac Radiol. 2011 Feb;40(2):67-75.
CBCT-based bone quality assessment: are Hounsfield units applicable? Pauwels R, Jacobs R, Singer SR, Mupparapu M. Dentomaxillofac Radiol. 2015;44(1):20140238.
The best method is CT in a scale of 1:1 separated for maxila and mandible in spite of CBCT alow the vision of each dental element
Why "CBCT is preferable" and why "The best method is CT ".
Would it be possible, to back up your statements with references?
The best method is CBCT, especially, when used technique Soft tissue cone-beam computed tomography.
Reference:
Soft tissue cone-beam computed tomography: a novel method for the measurement of gingival tissue and the dimensions of the dentogingival unit. Januário AL, Barriviera M, Duarte WR. J Esthet Restor Dent. 2008;20(6):366-73;
CBCT images
provide reliable information on bone quantity for preoperative
implant planning in the posterior region of
the maxillary.............this is from :
Veyre-Goulet S, Fortin T, Thierry A. Accuracy of Linear Measurement Provided by Cone Beam Computed Tomography to Assess Bone Quantity in the Posterior Maxilla: A Human Cadaver Study. Clinical Implant Dentistry and Related Research. 2008;10(4):226-30.
Its depend of the professional skill.It is publishing a comparative study of CBCT X CT,where we conclude the similarity of these methods
In my opinion, the choice should not be based on the professional skills, but on the advantages and disadvantages of each diagnostic method.
Literature is still controversial regarding accuracy: although there are references stating that CBCT would lead to better dimensional accuracy, the clinical relevance of this has not yet been discussed. Adding to that, there is the fact that deriving bone density from CBCT images is a known problem, and this should not be done. But, most important, we have to follow the ALARA principle, and latest guidelines claiming that the smallest possible FOV, together with the highest possible resolution should be used, in those cases in which a 3D evaluation will add substantial information to the treatment plan. With that as a background, the professional must consider which information is needed, adding radiation dose as one parameter which must be considered.
A comparative study of the accuracy and reliability of multidetector computed tomography and cone beam computed tomography in the assessment of dental implant site dimensions. Al-Ekrish AA1, Ekram M. Dentomaxillofac Radiol. 2011 Feb;40(2):67-75.
CBCT-based bone quality assessment: are Hounsfield units applicable? Pauwels R, Jacobs R, Singer SR, Mupparapu M. Dentomaxillofac Radiol. 2015;44(1):20140238.
I aggree partially with Rubens:the choice depends on the professional skills and for each case
No question . CBCT captures a cylindrical volume of data in one acquisition and thus offers distinct advantages over conventional radiography.These advantages include increased accuracy, higher resolution, scan-time reduction, and dose reduction. CBCT greatly aids in assessment prior to any oral surgery and RCT.
CBCT is now better. Minimal rx exposure and good accuracity. Another advantages of CBCT is anysotropy of the voxel. Based on this property you can prevent the deformation of the reformatted images due to positioning errors of the patient's head with respect to the CT scanner and you can use any post-processing software for multiplanar reformatted images.
The main problem is that CBCT is not a usual method for the public institutions
Hello: this is an interesting question;
We have been doing research in similar areas;
One of my students in orthodontics, (Dr.M.Wagner) did his master degree with me and his thesis title was:Dimensional accuracy of cone beam radiography: as compared with conventional lateral Cephalograms and direct measurements from dry skulls.
The results showed that CBCt is accurate compared to many other standard methods, then another student also I supervised did a study on CT scan entitled:
Determining Position of the Inferior Alveolar Nerve via Anatomical Dissection and Micro–Computed Tomography in Preparation for Dental Implants
Natalie D. Massey, BHSc, MSc; Khadry A. Galil, DDS, DO&MF Surg, PhD, FAGD, Cert Periodontist; Timothy D. Wilson, PhD, J Can Dent Assoc 2013;79;39:
The results were CT scan is also very accurate.
The problem here is that the CT scan is frowned upon these days especially in some places in Th USA because of many health problems arising from the dose (including cancer) , in fact they are trying to abandon in some states.
On the other hand CBCT is used by many dentist but there are no standard yet, we have tried to solve this problem with a study in orthodontics guided by the department of biophysics and I was an examiner in his thesis entitled: The Effective Dose of Different Scanning Protocols Using the Sirona GALILEOS® Comfort CBCT Scanner / by Dr.David Chambers
The results were encouraging in that it set certain parameters for using CBCT for obtaining best results with minimal dosages of radiation.(publication will come later)
So as you can see that in the long run probably CBCT will be more beneficial than CT scan.
Prof .K.Galil
Both are dimensionally accurate. The clear advantages of CBCT are that the radiation dose is significantly lower than traditional multi-slice CT and positioning issues are negated by the volumetric acquisition of information by CBCT.
I aggree with Steven Guttenberg.The main question is how we can measure the influence of radiation dose in the follow up of patients
The newer CBCT machines emit less radiation than traditional periapical and panoramic dental units that we have been using for decades without harmful effects. The information gained far outweigh the minimal risks.
Given the potential health risks, all non-essential radiation exposure should be avoided and systematic preimplant 3D imaging is to be discouraged. The alveolar bone widthcan be evaluated by ridge-mapping1 or by palpation of the edentulous process2 but may be overestimated on CBCT images. 1,3 For posterior mandibular implants, an experienced clinician can determine whether the width is adequate for implant placement. 2,4 The European Association for Osseointegration has stated that if clinical examination reveals adequate bone width and 2D imaging modality shows sufficient bone height, no further radiographic examination is necessary for implant surgery.4 Conventional and digital panoramic radiographs allow an accurate evaluation of the available bone height above the mandibular canal.2,5-8 A safety margin of at least 2 mm between the implant’s tip and the mandibular canal is recommended.8,9
1. Chen LC, Lundgren T, Hallström H, Cherel F. Comparison of different methods of assessing alveolar ridge dimensions prior to dental implant placement. J Periodontol 2008; 79: 401-405.
2. Frei C, Buser D, Dula K. Study on the necessity for cross-section imaging of the posterior mandible for treatment planning of standard cases in implant dentistry. Clin Oral Implants Res 2004; 15: 490-497.
3. Gerlach NL, Ghaeminia H, Bronkhorst EM, Berge SJ, Meijer GJ, Maal TJ. Accuracy of assessing the mandibular canal on cone-beam computed tomography: a validation study. J Oral Maxillofac Surg 2014; 72: 666-671.
4. Harris D, Horner K, Grondahl K, Jacobs R, Helmrot E, Benic GI, Bornstein MM, Dawood A, Quirynen M. E.A.O. guidelines for the use of diagnostic imaging in implant dentistry 2011. A consensus workshop organized by the European Association for Osseointegration at the Medical University of Warsaw. Clin Implant Dent Relat Res 2012; 23: 1243-1253.
5. Vazquez L, Nizamaldin Y, Combescure C, Belser UC, Bernard JP. Reliability of the vertical magnification factor on panoramic radiographs: clinical implications for posterior mandibular implants. Clin Oral Impl Res 2011; 22: 1420-1425.
6. Machtei EE, Zigdon H, Levin L, Peled M. Novel ultrasonic device to measure the distance from the bottom of the osteotome to various anatomic landmarks. J Periodontol 2011; 81: 1051-1055.
7. Vazquez L, Nizamaldin Y, Combescure C, Nedir R, Bischof M, Dohan Ehrenfest DM, Carrel JP, Belser UC. Accuracy of vertical height measurements on direct digital panoramic radiographs using posterior mandibular implants and metal balls as reference objects. Dentomaxillofac Radiol 2013; 42: 20110429.
8. Vazquez L, Saulacic N, Belser U, Bernard JP. Efficacy of panoramic radiographs in the preoperative planning of posterior mandibular implants: a prospective clinical study of 1527 consecutively treated patients. Clin Oral Implants Res 2008; 19: 81-85.
9. Buser D & von Arx T. Surgical procedures in partially edentulous patients with ITI implants. Clin Oral Implants Res 2000; 11: 83-100.
I agree with Dr. Vasquez that radiation dose is an important factor in patient evaluation. Fortunately, modern conebeam CT machines emit less radiation than panoramic 2D xrays. One can now three dimensionally image a jaw with only 4 microseverts of emission with CBCT. By comparison, normal background radiation is about 6-8 microseverts daily. The 3D information is accurate to 0.5 mm or less and offers clinicians and their patients a much more satisfactory and safer course than the archaic methods of ridge mapping. Here in the US, CBCT is considered the gold standard for the accurate evaluation of bone to receive endosseous dental implants. In addition, numerous law suits have been filed here for errors that have occurred during implant placement when CBCT has not been utilized.
At now in Italy, CBCT is considered the gold standard in dental implantology
first of all iam sorry in being late to answer and for Dr Erik Gotfredsen i offered my reference that is why i ask that question
The subtle width changes of the investigated
buccal defects were not performed in the current
work because the noise is high in CBCT machines
due to the lower mA used and because of the high
amount of scattered radiation since there is no postpatient
collimation. (20)
Noise affects images produced by cone beam CT
units by reducing low contrast resolution, making it
difficult to differentiate low density tissues thereby
reducing the ability to segment effectively(20)
orginal ref:Lee R: Common Image Artifacts in Cone Beam CT. AADMRT
Newsletter, 2008.
mentioned in paper named:EVALUATION OF MARGINAL BONE STABILITY AROUND IMMEDIATE IMPLANTS by Walaa KM Hafez;(1) Maha M. Hakam;(2)
Moshira M. Dahaba(3) and Sameh A. Seif(4) Cairo Dental Journal (28)Number (3), 1487:1494September, 2012
also another paragraph
although CBCT produce a much lower effective radiation dose (13-82msv) than multi-slice CT (474-1,160 msv) . it can nevertheless produce clear images ofhighly contrasting structures(31-33) in another paper named horizontal and vertical dimension changes of peri-implant facial bone following immediate placement and provisionalization of maxillary anterior single implant ; A 1-year Cone Beam computed tomography study by Phillip roe et al,2012 and this paper is downloaded for checking the references
also i will be glad to share a comparison between CBCT and CT in this word doc that i downloaded and i wish to hear your opinions and i will be glad for any comments or advice
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